實 實 虛 虛 之 誤 mistake of repleting excess and depleting deficient
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十 二 難 12th difficult issue
Shí 'èr nán 論 實 實 虛 虛 之 誤 mistake of repleting excess and depleting deficient Lùn shí shí xū xū zhī wù 十 二 難 曰 ： 12th difficult issue says Shí' èr nán yuē 經 言 ： Jīng yán 五 藏 脈 已 絕 於 內 ，when pulse of one of five zang organs is cut from inside, deficient Wǔ cáng mài yǐ jué wū nèi 用 鍼 者 反 實 其 外；and acupuncture repletes it’s exterior Yòng zhēn zhě fǎn shí qí wài 五 藏 脈 已 絕 於 外 ，when pulse of one of five zang organs is cut from outside, deficient Wǔ cáng mài yǐ jué wū wài 用 鍼 者 反 實 其 內 。and acupuncture fulfils it’s interior Yòng zhēn zhě fǎn shí qí nèi 內 外 之 絕 ，is separation of internal and external Nèi wài zhī jué 何以 別 之 ？ 然 ： Hé yǐ bié zhī? Rán: what does separation mean? explanation 五 藏 脈 已 絕 於 內 者 ，when pulse of one of 5 zang organs is cut from inside Wǔ cáng mài yǐ jué wū nèi zhě 腎 肝 氣 已 絕 於 內 也 ，qi of kidney and liver is cut from inside, deficient Shèn gān qì yǐ jué wū nèi yě 而 醫 反 補 其 心 肺 ； but the doctor instead repelets heart and lungs Ér yī fǎn bǔ qí xīn fèi 五 藏 脈 已 絕 於 外 者 ， when pulse of one of five zang organs is cut from outside Wǔ cáng mài yǐ jué wū wài zhě 其 心 肺 脈 已 絕 於外 也 ， pulse of the heart and lung are cut from outside, deficient Qí xīn fèi mài yǐ jué wū wài yě 而 醫 反 補 其 腎 肝 。but phisitian instead replets kidney and liver Ér yī fǎn bǔ qí shèn gān 陽 絕 補 陰 ， yang cut out, repletion of yin Yáng jué bǔ yīn 陰 絕 補 陽 ， yin cut out, repletion of yang Yīn jué bǔ yáng 是 謂 實實 虛 虛 。it is repleting the excessive and depleting the deficient Shì wèi shí shí xū xū 損 不 足 益 有 餘 ， decreasing not sufficient and increasing full Sǔn bù zú yì yǒu yú 如 此 死 者 ， it produces death Rú cǐ sǐ zhě 醫 殺 之 耳 。and phisitian is known as killer Yī shā zhī ěr |
Difficulty 12 explains treatment of excess and deficiency similarly as difficulty 81 and difficulty 75. One difference is that instead of one excessive and one deficient organs we have two excessive and two deficient.
1 In the case that kidney and lifer are deficient and heart and lung are excessive treatment may be following:
a Treating excessive lung which is a mother to deficient kidney and son of spleen we deplete spleen, replete kidney, deplete excessive heart increasing domination of kidney, but replete excessive lung, decreasing domination of the heart. In this case we replete excessive, treating what is in excess already.
b Treating deficient kidney which is a mother for deficient liver and son of excessive lung, we deplete excessive lung, replete deficient liver< which deplete spleen, increasing liver domination, and replete kidney decreasing spleen domination. In this case we replete deficient and deplete excessive, treating what is already is deficient.
2 In the case of the heart and lung deficiency and kidney and liver in excess we treat deficient organ instead of excessive. Nanjing explains two possibilities
a if we treat excessive liver which is a mother to deficient heart and son of excessive kidney, so we deplete excessive kidney and replete deficient heart, which deplete deficient lung increasing it's domination over the lung, it replete excessive liver as domination f the lung over the liver is decreased. Treating excessive we deplete what is depleted and replete what is already excessive.
b if we treat the deficient heart, which is a mother of spleen and son of excessive liver, in this case we deplete excessive liver, replete spleen, which decrease excessive kidney, increasing spleen-kidney domination and replete deficient heart as domination of the kidney over the heart is decreased. Treating deficient we replete deficient and deplete excessive.
1 In the case that kidney and lifer are deficient and heart and lung are excessive treatment may be following:
a Treating excessive lung which is a mother to deficient kidney and son of spleen we deplete spleen, replete kidney, deplete excessive heart increasing domination of kidney, but replete excessive lung, decreasing domination of the heart. In this case we replete excessive, treating what is in excess already.
b Treating deficient kidney which is a mother for deficient liver and son of excessive lung, we deplete excessive lung, replete deficient liver< which deplete spleen, increasing liver domination, and replete kidney decreasing spleen domination. In this case we replete deficient and deplete excessive, treating what is already is deficient.
2 In the case of the heart and lung deficiency and kidney and liver in excess we treat deficient organ instead of excessive. Nanjing explains two possibilities
a if we treat excessive liver which is a mother to deficient heart and son of excessive kidney, so we deplete excessive kidney and replete deficient heart, which deplete deficient lung increasing it's domination over the lung, it replete excessive liver as domination f the lung over the liver is decreased. Treating excessive we deplete what is depleted and replete what is already excessive.
b if we treat the deficient heart, which is a mother of spleen and son of excessive liver, in this case we deplete excessive liver, replete spleen, which decrease excessive kidney, increasing spleen-kidney domination and replete deficient heart as domination of the kidney over the heart is decreased. Treating deficient we replete deficient and deplete excessive.
